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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS O$NER BTII LDI]R OE[,('AR TIOII
<br />I lftb, dmrm ond6 Fnrlry of p6)ury rhd I m d.mpi nod rh. (nntd.roN' l.nte ll{ lor rh. fol['rinx rdr. (s< 70:rl 5
<br />Bum6r drd Protdxrn (ii() Anv ('ny oi Cou r $.n r.nut6 r Fni ro coNtucr,.t6, inFo\., d.mlilh or rp.n M!
<br />shdm. Fbrlo ns B@c.. rh. aq!u6 rh.4rlkat tor e(h Fnnn h liLr risNd ndmr rhd lEor {E n hc6E d FlNd
<br />lo lh. F.vnKB oftlE ConrEctorr l,'cos.d liv ((-hrfld e. ( onm.n.ina trirh s.crkrn 70xJ0 naDivision I oflh. BulinRt .nd
<br />PNGS6N ( o{.) o. rhd trM rtE t.rop rho!6o6 ed rh. tuE ror rlE llLs.d.t@fl'on Ary\'olrrion.f s.drn 70t15 hr.nr
<br />applic.rr ror !Fmn subjdrllE lr,Pli..nt lo t.ililp.m!tr'.fmr mr.rho nr. huRn.d d.ll&s(t50o)
<br />l.ao$..ofrlrFoFd\,arm]anhr6trnhu!A6&irhd{l..onFunu.u,ll.hrlE\drdrh.rndmEnn
<br />nlodoi o,olls.d lorslc(S( 70,la. BuriBr ud Prcfsn,B co& lh.(rntrdoi!Lt@1.{.h6Ntqphrouo\For
<br />rh.FDrEn} tr l$ hir& or mFor6 t,sm. ,n *hi rtE s.t ro* hrnr.ll o. hd*lf or lhrou8n ht or hd o*n mplo) c6.
<br />proud.tl rht! :uch inF.\odi e mr ird*rl fi ofitr.! tu sl lt ln$6s. rlE hiHin* or imFm@n n sB s ihn ok ta
<br />of corpLr6c
<br />'hc
<br />I xnd Blikjs * ill h!\r rlE hr&n of FrninS rhd h. d dr did frn hriu or inrrol. lh. F.p6l]' for th. BrFr oi
<br />l. a o\ffi of rh. F)Fre, m a.tur!.ry (oddins *irh lidFd..ntdod ro.o.dtud rh. !n,id (sa 7(x,1, Btr1nRr
<br />td ft.r*m Cod.: Th.ContE loir Licas uv d6 mt rgpll ro mo$nE ofFop6!, slF brild! or inpro\6 rhd6n.
<br />rnd *ho odn ri lor !u.h F.jer. sirh ! Co Eclo(s) lrcsaj pu6@r ro th. Conrruroa! l-ic.B lis)
<br />I m.rmrr undn S(rk)n
<br />u!f,tr};a!:gl!u[|Ll I(l!ot(l.!3dllat
<br />I h6.hy nmirn undd rEnrlty ofpfluryoncolrlE aollo*mt d(leoliotr\
<br />I h.* trd *ill Mrr@ ! ('dilE . of ( otkr k' Sclt lN,c f.. *ork6 co'npqldioi. 6 Ftr\ '(t.d
<br />for b S<rbn !7fi, orrh.
<br />tlhx Ca&, f{r llE pqfomN. of llE trorl for str.h th. pnnr i! rsu.n
<br />I har. .nd srll m.im.in trorlm .omp.Narbn iNur.n.., a r.quirc by sd irn I700 or $. liry cll(k. fot rh. p.rfomft. of
<br />lh. trortfqtrhrhrhirFnnr ir isEt M,$o 6 '.n 6uranc.ratr6 sJ Ii,|,.) iu'ntE r.
<br />l.d'li rhnt
<br />'n
<br />rhc Fformrre. of rhc r.rlr qhEh th!rqnri is kru.d.l snrlldx airh) an) F$n r rn\ nE6
<br />$ a!o tE om slt d r. rh.mrl6 NmFft.lio.l,a ofcrhfomri and asG lhd ifI shotrld tr.rm suti<t {o llE
<br />trort4' mmFBhn F.rbi,a of sd6. 17m of rlE l,bor Co&, I tdl f.dh$ irh snrplr s nh t r Fo\tioB
<br />WARNINC: llilur.lo suc rvo,hd o'rFlrdbn cov6r{. i! lnbutuL Md rh,ll $bFl u aryhtE lo oiniMl FEhk ud
<br />cNrl finB up r. oE hur&.d lln)ur*l 6ltdtlal0o.0oir), i..ddtrbn ro th..o.l .r&nFngrio.. drma86 s provid.d ln rhc
<br />sernr r(176 nfrh. l.hI CAl.. hr6d $d dr(n.l ! f6
<br />D.*, /t /i( hnlz ^,4*Lt ' u(Etsfr_(aa-LtAuaf,
<br />DICIdBAIIA!
<br />I hohy.fm undd paslryof Fjury rhn I e licaE d udq Foriir of CluFs I(commins |'rh S.dion 700r)) oll)nBion I
<br />ol lh. Bulir6r Md PmfdioN Cod.. d ny licds. is in alll lor.. sxl .ficr
<br />t,
<br />Il.c llf 0( /zo,tl ,r/72-
<br />qqlltral(lJoll.ElDllc-aclli(l
<br />I hs.by amrin und6 p.nolry o I pcjury lhxl rh6. ir 3 coNtudbn LnddB rtftr for rh. tcforll1m. .r ih. {oll fo. q hrh rhi rffi a
<br />$!0cd (S( 10c7, (-r\ c)
<br />l..nds'. Nim.
<br />AITLICA LDE(JIAAIIA!
<br />I h.rdry.trm unds polhy oaFjury orc ollh. follo$'I3 d(la.rions
<br />D.!reh'on t6m s-A3b6rG Ndrficnhn r.dd3l R.Soldrns(lnk r0. Pd6l
<br />R.qun.d kll(orfhrtum
<br />I cd'rylhar lh. Ld6alrc$ular()N rc3 dins sb.snBrtnF\.1,cnor i|)pli(ablcIo rh6prordr
<br />I co1'fy lhal I hav. r.ad thi! lrpli.d ion a,rl sl3'. rh, rh. .t \. infotun'n i! .o.d I .gN !o .onqi\ *nh .ll ('n) ..d ('oun'l
<br />.{dtum6 r'.j S'd. Lru\ Ehiry rq t{'ld'n8 confrdhn. d h6.t! rAhnd. ,(F6da! 16 c I rh( C(} d( ou.i) r.dr6 dt$. rh.
<br />ft.\. Mrh..d FoFn) ft, cpc{ni Frpo 1,,,' I t
<br />^**-,".u^|,o1../ Sa / L- -,. r1/a6/za/v
<br />p6tr -,. (p,ino: ,,2 ga,,tl /ermylz
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUlnsulation
<br />Roof Sheathing itl Trlil', Dg .tLiL *\
<br />Shear Wall
<br />Fram in s
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Mason ry
<br />Pool Fence
<br />T-Bar
<br />Handica Re q
<br />De Final Re rt
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL qlll'1, NI *4\+A
<br />Certificate of Occu pancy T' 1
<br />Notes, Remarks Etc
<br />7d =tllLL
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